Surgical prostheses, meshes, and grafts are commonly used in surgical procedures that include tendon and ligament repair, hernia repair, cardiovascular surgery, as well as certain dental surgical procedures. These prosthetic materials are fixated through the use of sutures, staples, or tacks. While such fixation methods have demonstrated success in immobilizing surgical prostheses, they are also a source of existing problems associated with each surgical procedure. In some instances, sutures may not be practical in certain situations where there is limited space or light source needed for suturing.
Hernia repair is one of the most commonly performed surgeries in the US. Although the use of prosthetic mesh as a reinforcement has significantly improved surgical outcomes, the rate of hernia recurrence remains as high as 30-50%. Moreover, current prosthetic materials are associated with numerous complications, including increased risk of infection, prosthetic shrinkage and host foreign body reactions. Such reactions often lead to changes in prosthetic mesh textile properties and result in a diminished postoperative patient quality of life. Recent advances in tissue engineering have seen the introduction of various biologic prosthetic meshes. These biologic meshes are derived from human or animal tissue modified both to preserve the structural framework of the original tissue and to eliminate cells potentially capable of instigating a foreign body reaction. Following implantation, these biologic implants become a site for remodeling via fibroblast migration, followed by subsequent native collagen deposition.
In addition to mesh type, effective immobilization of the mesh against the abdominal wall is also critical to the success of the hernia repair. Currently, both synthetic and biologic meshes are held in place with sutures and staples. While these fixation methods demonstrate variable success, their usage is believed to be a source of nerve damage and chronic discomfort. Thus, finding an effective alternative to sutures and metal staples would dramatically enhance the long-term biocompatibility of these meshes.
Tendon and ligament injuries have been occurring with increasing frequency over the last several decades. While methods for the fixation of torn tendons and ligaments have improved, none has proven ideal. The existing methods of using sutures alone or sutures with a variety of graft materials can create weak points at the sutures and require immobilization for a period of time after repair, before rehabilitation can begin. The evidence generated by the medical community is that earlier rehabilitation increases the likelihood that the repair of such injuries will be successful. A new method for repairing tendon and ligament injuries that would allow earlier rehabilitation and fewer incidences of post-operative pain, surgical complications, and rerupture of the repaired tissues is clearly needed.
Therefore, a need exists for improved materials and methods that overcome one or more of the current disadvantages.